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Vascular endothelial growth factor (VEGF) serves as a central mediator of vascular remodeling and neovascularization, essential components for successful pregnancy. This review aims to elucidate the diverse functions of VEGF in maternal vascular adaptations and placental development across the gestational timeline. Understanding the pivotal role of VEGF in maintaining vascular integrity, supporting placental function, and ensuring fetal nourishment is fundamental for comprehending the intricacies of pregnancy physiology and addressing pregnancy-associated disorders. Throughout pregnancy, the maternal circulatory system undergoes dynamic changes orchestrated by VEGF to accommodate the growing demands of the developing fetus. This section delineates VEGF\'s role in orchestrating vasodilation, angiogenesis, and increased vascular permeability, thereby optimizing blood flow to the placenta and sustaining adequate fetal oxygen and nutrient supply. Critical to fetal nourishment and development, the placenta relies significantly on VEGF-mediated processes for its formation and functionality. This segment explores VEGF\'s influence on trophoblast invasion, placental vascularization, and the establishment of an efficient maternal-fetal interface. It elucidates the impact of VEGF on regulating fetal growth, nutrient exchange, and the prevention of pregnancy-related complications. Disruptions in VEGF signaling pathways have been associated with various pregnancy complications, including preeclampsia, intrauterine growth restriction (IUGR), and gestational diabetes. This section delves into the clinical implications of aberrant VEGF expression and function, highlighting their significance in early diagnosis, risk assessment, and potential therapeutic interventions targeting VEGF pathways. Emerging therapeutic strategies aimed at modulating VEGF signaling pathways present promising avenues for managing pregnancy-related complications. This section examines potential interventions, including VEGF supplementation, receptor modulation, and innovative gene therapies, offering insights into their potential for mitigating adverse pregnancy outcomes associated with VEGF dysregulation. VEGF emerges as a fundamental player in orchestrating maternal vascular adaptations, placental development, and fetal growth regulation throughout pregnancy. A deeper comprehension of VEGF\'s multifaceted roles not only enhances our understanding of reproductive physiology but also unveils potential avenues for targeted interventions to improve maternal and fetal health outcomes.